Kao S C-H, Hovey E, Marx G
Department of Medical Oncology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
Asia Pac J Clin Oncol. 2011 Sep;7(3):212-23. doi: 10.1111/j.1743-7563.2011.01421.x.
Despite a survival benefit in the first-line treatment of castrate-resistant prostate cancer (CRPC) with docetaxel, the prognosis remains limited. There are increasing options available for patients with CRPC in the second-line setting, but there is currently little consensus regarding the optimal treatment. There have been numerous phase II and retrospective studies examining second-line options in CRPC, including retreatment with docetaxel, mitoxantrone, cyclophosphamide and carboplatin, which can be associated with meaningful responses in a significant minority of patients. In 2010 three randomized trials were published or presented which demonstrated a survival benefit in the second-line setting. These included cabazitaxel compared with mitoxantrone, sipuleucel-T (immunotherapy) and abiraterone acetate versus placebo. Ongoing research in the second-line setting of CRPC to optimize treatment options, with the objectives of survival prolongation, improvement in quality of life and pain management, is still needed.
尽管多西他赛在去势抵抗性前列腺癌（CRPC）一线治疗中具有生存获益，但预后仍然有限。对于二线治疗的CRPC患者，可用的选择越来越多，但目前关于最佳治疗方案几乎没有共识。已有大量II期和回顾性研究探讨CRPC的二线治疗选择，包括多西他赛再治疗、米托蒽醌、环磷酰胺和卡铂，在少数患者中可产生有意义的反应。2010年发表或公布了三项随机试验，这些试验证明了二线治疗中的生存获益。这些试验包括卡巴他赛与米托蒽醌对比、西妥昔单抗（免疫疗法）以及醋酸阿比特龙与安慰剂对比。仍需要在CRPC二线治疗中进行持续研究以优化治疗方案，目标是延长生存期、改善生活质量和控制疼痛。
